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Dr. Kenneth Wayne Vansickle JR., DMD
General Practice Dentistry in Santa Fe, New Mexico
NPI 1033196118

Kenneth Wayne Vansickle JR. is a General Practice Dentistry based in Nashville, NM and is specialized in General Practice. Kenneth Wayne Vansickle JR. practices in Santa Fe, NM and has the professional credentials of DMD. The NPI Number for Kenneth Wayne Vansickle JR. is 1033196118 and holds a License No. DD2304 (New Mexico).

The current practice location address for Kenneth Wayne Vansickle JR. is 2008 Saint Michaels Dr, Santa Fe, NM and can be reached out via phone at 505-474-4993 and via fax at 505-474-4973.

Location: 2008 Saint Michaels Dr, Santa Fe, NM, 37219-1994
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033196118
Provider Name
Kenneth Wayne Vansickle JR.
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
2008 Saint Michaels Dr, Santa Fe, NM, 37219-1994
Phone Number
505-474-4993
Fax Number
505-474-4973
Provider Enumeration Date
12/29/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
160531 01 NM UNITED CONCORDIA
9177992 05 NM
52823083 05 NM
institution
Provider Business Practice Location Address Details
Address
2008 Saint Michaels Dr
City
Santa Fe
State
New Mexico
Zip
87505-7682
Phone Number
505-474-4993
Fax Number
505-474-4973
person
Provider Business Mailing Address Details
Address
2008 Saint Michaels Dr
City
Santa Fe
State
New Mexico
Zip
87505-7682
Phone Number
505-474-4993
Fax Number
505-474-4973
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DD2304 (New Mexico)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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